Evaluation of Fecal Calprotectin Levels in Helicobacter Pylori-Related Gastritis: A Case-Control Study

Abstract

Background Helicobacter pylori (H. pylori) is one of the main etiologies of gastritis. H. pylori infection is associated with dense neutrophilic infiltration. When a process of inflammation involves the recruitment of neutrophils, elevated levels of calprotectin can be detected. Fecal calprotectin (FCP) is a noninvasive and less expensive test that is used for detecting and monitoring intestinal inflammatory activity. Our study aimed to evaluate FCP levels in patients with H. pylori-related gastritis compared to those with negative H. pylori. Methods This research was a prospective case-control study. It included seventy-two patients, who complained of upper gastrointestinal symptoms and were planned to undergo upper endoscopy. After upper endoscopy, gastric biopsy, and histopathological analysis, participants were classified into two groups. Thirty-six cases with H. pylori-related gastritis were enrolled as Group A, while 36 cases with gastritis and negative H. pylori were assigned to Group B as a control. Routine blood tests and stool samples for FCP tests were assessed in all participants. Results Mean FCP values were significantly increased in patients with positive H. pylori gastritis (38.5 ± 23.4 mg/kg) compared to patients with negative H. pylori (15.8 ± 12.5 mg/kg). FCP level at a cutoff of > 19.5 mg/kg (AUC 0.846) demonstrated moderate sensitivity of 86.1% and fair specificity of 69.4% when compared to histopathological findings. Conclusion FCP was higher in patients with H. pylori-related gastritis compared to H. pylori-negative patients. However, the discriminating cut-off value was within the normal reference value (≤ 50 mg/kg), rendering it impractical in clinical practice.